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HomeMy WebLinkAboutROUSE LT 4ARouse Lot 4A #050-321-73 Municipality of Anchorage Development Services Department * ", / Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www.cl.anchorage.sk.us (907) 3417904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: PID Number:��50-5� 1-7�� 1 `% Wastewater System: N New ❑ Upgrade Adtr•u PO�Ck % q1 T4 ('�.�M'/' 95%7 ABSORPTION FIELD proh. 6q q— $S Numha a 9Moomr �j'+ 0 Daae Tmxh O $Iuaaa Trarlt O sed 0 M"A q Oth- i3• LEGAL DESCRIPTION �° R'"° •D DPDd t' 70M Depth o" grw. 'Fl� FI. &a# to 8u4 .: u Depth ro ap• eottan "m edgrnal .a. FI. Duval depth Itenealh da O.or ^/ SFl T~V V Range, . s•cear Fe added aEpva original grade i L 43 ." Length. 37. FI. 5 Fl. Well: New [:1Upgrade G tmnW dm' � Na WNF owancow NMYNF FI. off. FL CIS A W (PMal1. A 6. CF Total Depth 7 C•.adnro 1 ^ a. Taal ap.ap•on a•a �SDFP P, wl.nal /;IL/0.'l"� il. FL .,T5TM F8 one, SVLL(v� Dw 1ed Su•e WalorlM to o �d n.Uaor STrr.oles Dole Installed I-��-a�f FL n�e,s3 Tal I 1, GPM pure sat al VOWA 7�: A.) FI. Ca.ng tl«am Aeov. Gnwnd �L FL TANK SEPARATION DISTANCES Ul septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ubliaPNvate ',I,F,^ From Tank Field Station Tank Sewer Line r,•`(•tp p-w �Dal well 131 las' a5'4-* "' 5-�ee aDa p•nnwx. saf.p.wola I6)+ 16" D LIFT STATION Laina 3' 35' 6q' ,1' ,. yrr� S 081 nu urar /e.nj / PIASf/4cs iaxMNbn S , L I S7{ 1 as •Puny ori t.v at �n 'Pump oK Ion* a. �a n 3 Nph Wt. M. al� n CwWn pain 6� e'e Lrodal E n r !F %/! R.maM1r • BENCH MARK Lo t*n and •apq, o n� Nraeon 100 FL sP••a '.1 i* 49tH S&3KNOINL[RIN 5P River, � y� Inspections performed by: 17034 `egle RiverLeap Read, No. Dates: 1't I" ''f' iJy � • " • yj 2 Development Services be artment Approval 7ams -986 •V��i � Reviewed and approved by: jOLD t Date: . IjQ'•�.....•�`�'t`� PERMIT N0. SW040438 PACE 2 OF 3 Municipalit of Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 •Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 4A, ROUSE S/D P.I.D. No. 050-321-73 ROUSE CIRC n�— Le -- \ \ \ FVt—r \ \ \ \ MT2 \ \ 4 TSM: \ \ N \ \ O \\ \\ THy2 ? TTHLL/J1 \ \ Q \ \\ MH STI FC \ \ ST2 \ TO McCRARY ROAD 0 �S OW ON wpm Zw0 M'I' 3 G 20 DRAINAGE EASEMENT SCALE. 1' 40' .��Ci:� �C•.s �t ,*:'49TH •*� /•• �' �•• Collin K. Whams •'� ; PERMIT NO. SW040438 PAGE 3 OF 3 Municipalityof Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 •Anchorage, Alaska 99519-6650 • Te'lephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 4A, ROUSE S/D P.I.D. NO. 050-321-73 ST1 FINAL GRADE ST2 94.3'Z I NEW 1500 GALLON SEPTIC TANK MTI =98.8' MT1=93.7' DIST. LINE=93.9' 96.9' � 2" INSULATION 94.1 i 96.4' CONDUIT 550 GALLON FAT ALBERT WITH PUMP ASSEMBLY GRADE MT2=98.3' MT2 INSULATION ua ux[ liui0 A GROUNDWATER AT 87.8' 84.8' B.O.H. MT2=91.8 DISCHARGE PIPE ORIGINAL GRADE N. T. S. WALKER ELECTRIC CLINT WALKER Flxw 696d89(A Cel N 223-6304 Fl it ClintAlan a ool.com To: Michael Quinn Const. PO Box 772641 Eagle River AK 99577 Date : 6-22-05 Ref AA Rouse Permit: 10319 Cohille St. GAOLC R1VrR AK, 99377 Liwrtw N 1310 This is to certify that on site sewer lift station at above mentioned property has been wired in accordance with the standards of the National Electrical Code and manufactures specification. Systems were checked and performed as specified in the systems manual. Clint Walker FROM : MICHAEL OUINN CONSTRUCTION PHONE NO. : 907 6944956 Jun. 28 2005 1O:3OAM PS 01/01/1999 00:01 6882259 bULLIVNN ��•� �•��� Certifieb' �Mriiliitg og by SULLIVANWATERWELLS PALeaas mcfalouuCALASKAfI'll • -.- ' . - we ID �� s.�r94 �rrranfet3f:f24c43� oefecita,a�R,.-II�-JLy �unoExtstcr�mou nt�.a�-.3�1--�_ Iswab�bdda0iO�o+odP�a�° � .'�prr Weaddomew t w'w' tFy CACA" oaf DWMC(uV& 32b Loft jla_,T0R4e_VQlrftlMw 125'a .idles Ctadw 11 it - - awm , Ii feef c&fm=ov lEoosf31wxt one swc Wwo LCM*— 6D feet t;emovRnbtltlfim falt�oeof7eser� l�iJ/ylp Tc5 % vo - a o www t�TfDb 3$1aan4. tma a1d SWW id.e WE sw �c fo11 Depot koa Q fol. is Au bd ld Old I 'I UPM CDMPrme b'96 Oft Wend d ObY�le+dlore _C..Y4a�• •.rL s��rn w�ro� rtY�ORor�r��=d �r . r_ 'S`r7G.c J b%W,CA d rr49a QB�seaC.k. 6,Qd./ orffe�rs t�a,10 Ii�iie S...�- tTiFl TKK k Is Vo ro@Pomgbft of IAs POWOgl Cumw fo UAW& a COW d the we! bO 10 *0 POW a*MfllX MwddDdt:Y :f k-d1af1 g Depsemert d MfWM d Numan Smvbes andor DopwWw t of E1se6afenardal Cons vo m l osu smavoz X"tis nt of &wkxwr#WW Qonstvaf % MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Permit Number: SW040438 Legal Description:', ROUSE SUBDIVISION LOT 4A Design Engineer: 0003 S & S Engineering Owner Name: MICHAEL & MARTHA OPPERMAN Owner Address: NHN ROUSE CIRCLE CHUGIAK . AK 99567- ll/d4/oq q ,Door, 11•00QsrN Date Issued: Oct 18, 2004 Expiration Date: Oct 18, 2005 ParcelID: 050-321-73 Site Address: NHN ROUSE CIRCLE Lot Size: 57450 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 2permit Is for the co ction of. ]Disposal Field [`� Staeptic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. VS E_rc7,NEeR,,v,5 O_--rjcN CNhN(Z DJI: Tu "OfJn/0 W'frFR. Received By. THE NEW HPOPoSro Seorse =ysrFM WrL-c. is's f}N IDS F, WHrcli Wtc-c. ?E S/Z�co Fort + S TrOr2opn,. %)AN Ro7q 6V7—W0Ary4Fv Ti{E IO,S.r. us'q Fort A S 3lzoozoo". Date: e io Y Issued By. �� Date: ID1, 9 c Municipality of Anchorage Development Services Department Building Safety Division ': "r= On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 125&- Property owner(s) n� i Mailing address (1) PO .3.')1- /q3 Permit Number SW C , / / (1ghA,- �Qnr a ry �� vt Day phone �gr q-y9�5 Box%7�?Xq/ Mailing address (2)—Lok. "RgosS!: Zip Code 94574, - r t1 A Legal description (Lot, Block & Sub'd.) Lo -f !/r, Legal description (Section, Township & Range) Lot Size --6,'q, q� _Acres q.F Number of Bedrooms 5 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. /7 / 1 b 5 ENGINEERING 17034 Eagle le River River Loop Road No. 204 (Signature of property owner or authorized agent) Permit Fees: A ji G 0°`f_ s 1 7,S . �- Waiver Fees: Date of Payment: _ 110 /1 y /0 Date of Payment: Receipt Number: S 9 6 N Receipt Number: (Rev. 17100) November 17, 2004 POPERY C. COWAN, P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 WAOVAU DitlTM movAls APMUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER & WATER MANEXTENSIONS REFERENCE: Lot 4A, Rouse Subdivision INSPECTION ER It is requested that you issue a permit to install a new well and a new septic system to serve the proposed five bedroom dwelling on the referenced propertyeX s "4 C H.404191 WORKCO OvTENGIA+I sI/ .19�✓ R�tH TO t/i4 I,OSF Fut FI✓4. BCF Rp•n J, Q Two test holes were excavated and percolation tests performed. The approximate locations �O y AREro�R 9TUOE6 of the test holes are located on the attached site plan. At the time of excavation (11/14/00) water was found at 7.5 feet. After monitoring, ground water was found at 7.5 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WELL areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITEPWIS If you require additional information, please contact us. Sincerely, ROAD DESIGN - /17� SM TESL *RoertC. Cow RCC/bjj Enclosure PERCOLATION TEST STRUCTUNµA MEOWW-AL NSPrcnow CNSITE WASTEWATER D6POSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 1 " = 60' <? F 0 x � o , t" Ono / n IT> / \ agpIC.'n M ALT um , ;u>g' T "� �z s ONO a I � ONOO -0 C) 7 N O p —n ^r d / C Iz 0 rm m 0 t" T 1 / '1NN ;o / \ agpIC.'n M ALT H ;u>g' T "� _ I DESIGN I SITE -PLAN RAINWATER CIRCLE / K 11M3Al00 . 01SWO.0 M 10' TELECOM & ELECTI W -•WW V N :N G Q rp'rm 0r,0m I Z �-0 0 Im ;EMENT 9qo nM >On� t" '1NN ;o m \ agpIC.'n M ALT H ;u>g' T "� K 11M3Al00 . 01SWO.0 M 10' TELECOM & ELECTI W -•WW V N :N G Q rp'rm 0r,0m I Z �-0 0 Im ;EMENT 9qo nM >On� t" '1NN ;o m Ci O II ;u>g' •` "� s ONO 0 y N m r r O 0 —Vw(n v cn0 NOr.m t" '1NN ;o m Ci O II °IINu7 •` "� ONO ONOO -0 7 N O p —n ^r TI rti a ^" ZI m v i/' p D 0 O AO�z ?�AIp D OGS DSA -<<N O n r no, >no W <�C Dmp z ^O _ O .• L C L yvn C t y�C C I " = 60' DESIGN SITE—PLAN I O�M 0 (N "" W W N Z9 A I V N QUI �na� NN N*'�v \ I cn°o :D>O � m 1•� �prn o cn :S•z nmHe MITA m n r�I � �nx _ �.� < nN� Q � \ aT I 0 \ N Z9 A I NN \ I :D>O � m y0 Dml -,r0 i >rN XpO 7C M x N ALT. SITE 3snOH WOONO3G S 03SOdONd Avm3AI80 03SOd08d. O i N \ r Q � � T1NN.Z1 oll3 W 0 II II NII 7 ` i--3 NWS O I oN�o N > C I / En / En -4 o o M ^ m p n ` 1 � I V I I 0 a A �a o` 0 9 XAQ,Z N. zr9 m r M O A TI < W N Z O a DESIGN SITE—PLAN C <0 n �4 W— W W 1� so V N =N `~ :no �1 N C � Q r- Ej VI V VDA > z 0 rq ri oll3 n z-�'8 < C N �uNs r] ^ bvO b P .fin. 32 No n m a C <0 n m L A `~ 5 �1 N r P oll3 n m II II NII C N LLn A OV y .� O V�O C� e e CA 0000 r Yy +q 0 w -3N sa C17 ag � B L ti p.N-1 76 st � f � o � ns r v Y N k n 7 W V op� I �on �1 pAmO P zy n s�z z- w �?o O XOa sw �� oN '9 qS qA �2 (510 N7 `N A n D P� m n N — v Cn Ln O N O C L A `~ 5 �1 N r oll3 n m II II NII C N LLn A OV y .� O V�O C� e e CA 0000 a d J +q 0 w -3N CA Go _mc �7 f1�7 ti p.N-1 76 st � f � o � ns r v Y N k 7 W V op� I lj �1 pAmO P zy n s�z z- w fiN O XOa sw �� oN '9 qS qA �2 (510 N7 `N A n D P� n — v Cn Ln O N O C tn0rm Ln `~ 5 �1 N oll3 n m II II NII % LLn A OV .� O V�O C� N CA 0000 +q 0 w -3N CA m M'1� ti p.N-1 m � f � o 1;00_ v Y � k 7 W V y I lj �1 pAmO zy s�z z- w fiN O XOa A n D 0 n Performed For. h Legal Description: hf t,- 9- 10- 11- 12- 13- 14- Is- 16- 17- 18- 19- 20- Depth Municipality of Anchorage Development Services Department Building Safety DMs1on On -She Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 995198650 www.muni.orglonsits (907)343.7904 Soils Log - Percolation Test -V 6)FPFvXrt n-rU TElr lloLj 7i Z Situ—Or...E:�})u1cS n W00,01 WAS GROUND WATER Date ENCOUNTERE07 Net Time Depth to Water Net Drop 8 IF YES. AT WHAT DEPTH? '� L Depth to Water After Monitoring? O 7 S 1 E Date:t l I 1 67 .../ r )} NGINEE 'S SEAL •.,'� ' i nC t r `% COWAN 4l+A�ci CE -8801 (lit rt'•:i��.,`•' Performed: Reading Date Gross Time Net Time Depth to Water Net Drop 3y -- (� N _^ .cn�wnriur+nnrt a// (mYwleNwe PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 5 FT COMMENTS 5 & 5 ENGINEERING 1 e PERFORMED BY77=4 9 6 River Lnnn Rn.A u„ '3041 < CERTIFY THAT THIS TEST AS PERFORMED IN, I E AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: // /(Otl o• I = ro e111t0/ocli 3 o ' S& NEA7NAUTNORI7Y APPRCNALS SEWER& WATER ANN S(TEISONS SEWER& WATER NSPECTICN EMMNEMMSTUCES ANOREPORTS WELNSPECTM &FLOWTEST SITE PWS GMTEST PERCOIATICN TEST STRUCTURALe &Eaw+ICAL NSPECTIONS ONSITE WASTEWATER OSPCSALSYSTEAI OES CN ROBERT C. COWAN, P.E. CMLENGINEERS (9M 6942979 FAX(907)694-1211 INTERMITTANT DOSING SAND FILTER SPECIFICATIONS Lot 4A, Rouse Subdivision November 17, 2004 GENERAL STATEMENT OF WORK The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations. The scope of this project includes the installation of a 1500 gallon septic tank, a 550 gallon Fat Albert S.T.E.P. tank, and a new I.D.S.F. septic system to serve the proposed five bedroom residence located on the referenced property. SITE INVESTIGATION The Contractor must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility of performing the work as stated in these specifications and drawings. Location'of utilities will be the contractor's responsibility 17034 NORT14 EAGLE RIVER LOOP & SutrE 2o4 - EAGLE RIVER ALASKA 99577 Page 2 Lot 4A, Rouse Subdivision November 17, 2004 SEPTIC TANK / LIFT STATION / AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials 1. Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. 2. Manhole Riser or Lift Station Tank •M a. An additional second compartment manhole riser shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: 1. A 110 volt or equal U.L. Listed effluent pump. 2. High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. Page 0 Lot 4A, Rouse Subdivision November 17, 2004 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of: 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 wattheater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (oil) (H.O.A.). 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. d. The airline from the house to the filter is to be HDPE arctic insulated pipe 3/4"-2" SDR - 11. The compressor will have a gauge (0-10 psi) and be extended into the living area or garage for easy monitoring by home occupants. 4. Air Compressor Page 4 Lot 4A. Rouse Subdivision November 17. 2004 a. Air compressor shall be a THOMAS LINEAR SERIES model number 5060-A or 5070V -A or M.O.A. approved equal. CONSTRUCTION SEQUENCE In order to insure proper installation, the system is recommended to be installed in the following order: 1. Sewer line from house to tank II. Septic tank/lift station M. Sand filter IV. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines Page 5 Lot 40. Rouse Subdivision November 17, 2004 The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that maybe required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. Page 6 Lot 4A, Rouse Subdivision November 17, 2004 SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. b. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. All nand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ t 0.05'). e. Sidewalls and top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow WF16-4-24 150 LF placed 6" above bottom of sand. Page 7 Lot 40. Rouse Subdivision November 17, 2004 Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE Building Safety Division DATE: November 18, 2004 MEMORANDUM TO: ON-SITE FILE FROM: Joe Goodalat Engineer II,e Water Wastewater Program SUBJ: ROUSE S/D LOT 4A 11/18/04 - S&S ENGINEERING DESIGN CHANGE DUE TO GROUNDWATER. THE NEW PROPSED SEPTIC SYSTEM WILL BE A IDSF WHICH WILL BE SIZED FOR A 5 BEDROOM. DAN ROTHN AUTHORIZED THE IDSF USE FOR A 5 BEDROOM HOME. October 14, 2004 ROBERT C. COWAN, P.E. CMLENGINEERS (907)6942979 FAX(907)694-1211 WXTHAUNHORTY MUNICIPALITY OF ANCHORAGE APPWN&S Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 SEWER L WATER &WPM E%TENSIONS REFERENCE: Lot 4A, Rouse S/D ETu CION It is requested that you issue a permit to install a well and septic system to serve the proposed five bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of ° DREPOR° RT3T,S1D the test hole is located on the attached site plan. At the time of excavation, 11/14/00, seater was found at 7.5'. After ground water monitoring, water was found at 7.5'. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WELLINTION &PPUOINSPPTEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITE PLANS If you require additional information, please contact us. Sincerely, ROAD DESIGN Robert C. Cowan Soc>EST RCC/bjj Enclosure PERCOLATION TEST STRUCTURAL& MECNAlMIL INSPECTIONS ONSITE WASTEWATER DISPOSALSISTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 r C \ o � z 0 rOo m 0 O S / IO V / r� �V1 L J N (11 / n / / owe / +oaDoo 's k . I f Y,$I FI DESIGN I SITE—PLAN RAINWATER CIRCLE —L, — W to bbb m�mv vv�rn Zmm-0 !t% o � / ::j O I N / I / r� �V1 L J N (11 F�1 I N ' n / / owe / +oaDoo Eo c c i► c o I\ o o n9 —L, — W to bbb m�mv vv�rn Zmm-0 !t% o � 0 ::j O I N / —L, — W to bbb m�mv vv�rn Zmm-0 !t% 0 ::j O I N / I / r� �V1 L J N (11 F�1 I N ' —L, — W to bbb m�mv vv�rn Zmm-0 !t% 0 ::j O I N < 10 M I r� �V1 L J N (11 F�1 I N ' I / +oaDoo TELECOM & ELECTI CAD V CA Ln N O_ \r0 N � II � II NV N O N Ln O O P N v O n O 714, '-1 .i7 m D / 0 0AmO ap�z !GAZA s o=os=o z- K�YI X 0 A D � O <�C smA 0 N z 0 o 0 L ::la+clypEk•i Municipality of Anchorage ; i ' DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 .............. SOILS LOG — PERCOLATION TEST r n; ROEERT C, COWAN 1t °i3 : CE - P801 PERFORMED FOR: DATE PERFORMEDt:) (`�• " h-tl' WII ^- �j LEGAL DESCRIPTION: T 4A , 12O[.L� �/O Township, Range, Section: (FEET) 2 /A'-` SM�O� Pf tO c W Z /� 3- 4- 5-0"' 45 Q... 6 O 7 O;, _ GM / 8 10 11� (9 119•JI 12 13 -I 1ew i.;' r /0/b/py 14 15 16 17 18 19 20 COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT % / L DEPTH? C J O P E- t1P.y / � E Dept to Water Aver Monitoring? Gait. I / PERCOLATION RATE ° (mmutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 1< S & S ENGINEERING Ce .l *4 L' PERFORMED BY: C. 1 ,EA CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WA*gkP*KT0kfgiI kAtWITPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: I / �- G /O 1 72-008 (Rev. 4/85) RVA ROBERT C. COWAN, P.E. CMLENGINEERS (907)894.2979 FAX(907)094.1211 ON-SITE WASTEWATER DISPOSAL SYSTEM A rnw woman CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWER& WATER MAR! EXTENSIONS REFERENCE: Lot 4A, Rouse S/D October 14, 2004 SCR&"TER GENERAL: 1. The scope of this project includes the installation of a 1500 gallon septic tank and new trenches to serve the proposed five bedroom residence located on the ENaNEERwcsTwlEs ANDREPORTS referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all PECTIM a XSTT applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESKW 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their S4X,E,T owT1 systems must also receive prior approval from the Municipal Flealth Department. E1CO1AT0N TEST T SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. aTRucTulALt WC/UMCAL aSPECTICM 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER =POSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 Page 2 Lot 4A, Rouse SID October 14, 2004 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCIUDRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 4A, Rouse SID October 14, 2004 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must confonn to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 4A, Rouse S/D October 14, 2004 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907,343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-321-73 1. GENERAL INFORMATION Complete legal description Rouse L4A Location (site address) 18530 Rouse Circle Current property owner(s) Sher Mailing address Expiration Date: Day phone 230-9336 Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Z Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ / q _-G) Waiver Fee $ Date of Payment Receipt Number COSA# nJG22- )265 Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Address PO Box 770724,, Eagle- River Engineer's Printed Name Steve Eng 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone 694-7028 Date 4/30/22 Conditional approval for bedrooms, with the following stipulations: ­rV 11%r- wl ON-SITE, A 1046,TER WAS�r_ tA[VU r') _,V"ATER PROGRAM By: c Original Certificate Date: 6, 2.2 The Municipality of Anchorage Development Services Division (DSD) issues certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Ct,-.eWist blue sheet Legal Description: Rouse L4A Parcel ID: 050-321-73 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 1.5 gpm Date drilled '0'2"04 0 Water storage tank volume gallons Total depth 320 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 24-bdrk ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 4.43 mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 24+ in. Collected by NRimEng Date of flow test for COSA 8110120 Date of Sample 5/5/22 Static water level at beginning of test 24.3 ft. Comments B. TANK DATA Age of tank(s) 18 years Tank type/material Pb_t ' Measured operating fluid level in septic tank 48.5 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 5/31/22 D. ABSORPTION FIELD DATA 11/24/04 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station 18 years Lift station material PIStc Comments: A+ Maintenance Adequacy test date 8110120 Results R Pass For 5 bedrooms Fluid depth prior to test 0 in Water added 750 gal New depth 1 in Elapsed time 30 min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 750 gI - (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet :7. SEPARATION DISTANCES :rorn Private Well on Lot to: (Please enter distances it less than required or it community well) Yes. if No ft Surface Water > 1001 3eptic Tank/LiftStation on Lot > 10011 Droperty Line > 5' 0 Comm Sewer Manho I le/Cleanoui if No, > 100' Wells on Adjacent Lots: Ye's if No. ft Yes it No Yes if No ft q eig hboring Tank > 100' � Yes if No ft Private-Sewer]Septic Line> 25' t F -71 Yes - if No ft Nbsorption Field on Lot > 100' � Yes if No ft Holding Tank > 100' CJ Yes if No ft qeighboring Absorption Fields > 100" Animal Containment 50' Yes if No ft Yes if No ft 1> Manure/Animal Excreta Storage > 100' Tff_ ,ommunity Sewer Main >75' Yes if No It n Yes it No ft =rom Sept! ca/Holding. Tank on Lot to: (Please enter distances if less than fe quir6d) 3uilding Foundations> 10' Yes. if No ft Surface Water > 1001 Yes if No ft Droperty Line > 5' 0 Yes if No, ft Wells on Adjacent Lots: Nater Main > 10' absorption Field > 5' Yes Yes it No ft Private Wells > 100' R Yes ` if No ft Nater Main > 10' if No Yes if No ft Community Wells > 260' P/1 Yes. if No ft Nater Servioe Une. > 10' ft Yes if No, ft If septic tankis under driveway comment below =rorn Absorption Field on Lot to: (Please enter distances iffless than required) 3uilding Foundation > 10' Yes if No ft If absorption field.' is under driveway comment below property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Nater Main > 10' r -D Yes if No ft PriVate,Wells > 100' Yes if No f I t Nater Service Une > 10' Yes if No ft Community Wells, > 200' Q Yes if No ft Surface Water > 100! Yes it No ft ENGINEER'S COMMENTS AX OF J/ 44 Tff_ ENGINEER'S, CERTIFICATION IPA— Steve Eng I& T a I certify Mat / have determined through field inspections and review CE 6256 of A.4unicipal records� that the above Mtems are in conformance with MUNICIPALITY OF ANCHORAGE } L Development Services Departments Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-321-73 1. GENERAL INFORMATION Complete legal description Rouse L4A Location (site address) 18530 Rouse Circle Current property owner(s) Kirk Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Expiration Date: //-2-5-. !-2-5 Z 6w Day phone 830-7806 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment 8 1' 8 020 Receipt Number Qa / 0N Receipt Number COSA # 0 S C 2-0 1 L y 3 Waiver # Waiver Fee $ Date of Payment 5. STATEMENT 0'F INSPECTION BY ENGINEER As certified by my seal affixed hereto and .as of the valida6an date shown below, I verify that my investigation, based on procedures outline -d in ehe Gertifirale sof Qn-SiteSystorns Approval Guidelines for this application, shows that the on -sits ti ter supply and;or wst vlater disposal stirstem is (are sage, funck cnal and .a+de�q€�ate to the number of bedrooms and type of structure indicated herein. I further 'verify that based on the information obtained from the Municipality of Anchorage tiles and from rr7y, investigation and inspection, the on-site water supply and,or lovaslewater disposal systiarn i (ere) In carripli nen with all applicable hAuninipaI and State coders, rrdina!nces, and regulaflons in effect at the time of Installation. I arkn,ovAedge that On -Site staff may visit the s to to verify the information sufamUted. Name of Firm NorthRim Eng. Phone 694-7028 Address PC Box 770724, iEagle River Engineer's Printed Name Steve Eng Dote 8/12/20 6. DSD SIGNATURE .System n"I Approved for bedrooms System 112.A:pproved for bedrooms Disapproved Conditional approval for badrooms, ++OF jW s * : 49 TH,�:...ut... ��... * ♦t ` Steve Eng CE -6256 Ar vrith the toflowing stipu 22n's: ON-SITE AIAT-F-RAND 0 WAST' vVATER oz J T _ _ _ J 1 `} J � /J SER\J\G���`1,� Mw- 7m,-rn . By- Original Certificate Date:91zS- 2020 Thi* Mwiicir.rality C•1 A;radhorage D[:voloprriont Seevico% Diviz�iori -(DSD) issua= Ur41riems oP a i-Sito SystorllsApprav@l rCOSAfi baso ur:ly upiri Phe regre-s�nl.ahon giveit in pcifagrapli 5 by an ir,,japGndc-ns p oft sEjot%_il civil engirteer registered Ir.. a11e State of Alaska. The Livnicipalitr f N,e..",rogie Is not ren ors ihle fox error, a; orrissians in the professinnel encaineer's k%.urk. 7. ATTACHMENTS-. OOA C17or:k1lst X Nitrate Advisory Septic Syster-r Advisory Arsenic Advisory Well Flow Advisory Other rr I&L Clp'kCai 1.1no .�.• Legal Description: Rouse L4A If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 10/16/04 Total depth 320 ft Cased to 24-bdrk ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24+ in Date of flow test for COSA 8/10/20 Static water level at beginning of test 24.3 ft. Comments B. TANK DATA Age of tank(s) 16 years Tank type/material Measured operating fluid level in septic tank 48.5 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 4/15/20 D. ABSORPTION FIELD DATA 11 /24/04 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ Systempresoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050-321-73 of Structure served by this system Well production at time of test 1.5 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 4.81 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 810/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station 16 years Lift station material p[StC Comments: A+ Maintenance Adequacy test date 8/10/20 Results Q Pass For 5 bedrooms Fluid depth prior to test 0 in Water added 750 gal New depth 1 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 750 gpd Any rejuvenation treatment (past 12 months) If yes, enter date no :rorn Private Well, on Lot to: (Please enter distances If less than required or it community well) Septic Tank Lift Station on Lot > 100' Yes Community Sewer Manhole/Cleanout > 100' ft El Yes if No ft 0 Yes if No ft q eig hboring Tank > 100' 21 Yes if No ft Private Sewer/Septic Line > 25' M Yes, if No ft absorption Field on Lot > 100' � Yes if No ft Holding Tank > 100' -71 Yes if No ft �lejghboring Absorption Fields > 100' if No ft Animal Containment > 50' R Yes if No ft Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' ,ornmunity Sewer Main > 75° F-11 Yes if No ft Yes if No ft -rorn Septi c/Holding Tank on Lot to: (Please enter distances if less than required) 3uilding Foundations > 10' Yes if No ft Surface Water > 100' Yes if No ft property Line > 5' if No ft Yes if No ft Wells on Adjacent Lots: if No ft Nbsorption Field > 5" Nater Service Line > 10' Yes if No ft Private Wells > 100' R/ Yes it No ft Nater Main > 10' Yes Yes if No ft Community Wells > 200' P/1 Yes if No ft Nater Service Line > 10' Yes, if No ft If septic tank is under driveway comment below =tom Absorption Field on Lot to: (Plea, -se enter distances if less than required) 3u ilding Foundation > I O Yes it No ft if absorption field is under driveway comment below 3roperty Line > 10' Yes if No ft Wells on Adjacent Lots: Nater Main > 10' Yes if No ft Private Wells > 100' Yes if No ft Nater Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Yes if No ft ENGINEER'S COMMENTS ff ce, ;4 ENGINEER'S CERTIFICATION I Q: Steve Eng % CE 6256 I certify that / have determined through field inspections and review (N 7, of A&nicipal recorM3 that the abovesysterns are in conformance with W1 �d'6 ,P: 911 71 -?43-79D4 - F-, 0517 -P.O. Bm 19600 A,-4bwac-_ AK 919519 -66 -SO Intermittent Dossing Sand Filter Maintenance Log (Xvner z,caa1'_ LrK__ P h o n Legal w0esc_ PID SaRlin Tank: -Sludge level _� Absorption Field: -Liquid level inches -Pumpin.g. required xcis 4D -Pumping completed yes rfijo) -Flushing valves per approved design COS) no -Afiflu3hing valves opor_tiJ, clisIribution line,:, hushed, and flushing valves Closed )IJo-h_,j GEL no Lift station: -Pump basket cleaned y _E_',�n o -Biotube effluent filter cleaned -Tmer float setting inches in4L;hes -High level goat setting2]� -Reference pointT -Pump on inches 0 , _seconds IQ)Q -Pump off minutes iQ) -Cumulative lifetime oyole. -Cumulative run time hours ___ -t -Openalkion sarisfactorl �Lqh nq )VI9 Air SVstem: ,Air pump filter cleaned 01� p r r 0 -Air pressure ,Date of Latest install or rebuild 1) 90cAI"O -Air system operation Alarm Pys m: N S -j le .Dedicated electrical circuit pp -Audible and visual' alarm inside dwefling -Float setting . (a no 'Alarrnsystem operation 6*�faeior�x notsatiergelory Comments: ........... ....... ......................... .... . . .... \ 1,4 ............ Mainteiiance Provider: Technifjav, Date of maintenance LI -1960-0210 Company " J9 QIO� AIM'o-Sem` _j Signature . .... . . .. ...... Municipality of Anchorage • Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-321-73 1. GENERAL INFORMATION Complete legal. description Location (site address or directions) ; 1 R S '4n a n„ 4 a r i r Current Propertyown6r(s)Michael b Martha Opperman Dayphone 694-4955 Mailing address PO 'Box 772641 Eagle River, AK 99577 Lending agency Mailing address Real Estate Agent Mailing Address Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. Z,`' ,.,_ -7 / xq! os 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well fft Individual On-site U Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B welts or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S a S FnvinPPring Phone 6q4-7.g7q Address Engineer's Printed Name 5. DSD SIGNATURE _Approved for bedrooms. River, AK 99577 Date 42 Z/6!57 )F, A(qs % *;497" F;� - ' Colon K. WOOS •'4Z CE -9867 �n _••....•l.�t� Disapproved. - %����— Conditional approval for bedrooms, with the following stipulations: ix: WATER AND Additional Comments 1■" c�TENJAFT€R PROGRAM ;. Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By -4 , p g�, 0 j�,y Original Certificate Date: (R*, 01107) D Parcell.D. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. ' O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ' E RTIFICATE OF HEALTH AUTHORITY APPRC ' FOR A SINGLE FAMILY DWELLING 050-321-73 HAA # 6 91- Expiration Date: _ GENERAL INrORMATION Complete le0al description Lot GA• Rouse Subdivision 's Ige3v Location (sit eaddress'ortlireCtioii5}j tuPtt Rnnar r.ir Current Property owners) �11`ch13e1 S Martha Opperman Day phone 694-4955 Mailing address : P0.rPx772641 Earle River, AK 99577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: ^5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well U Individual On-site El Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S s S Enginepring Phone.Ag4_7g7q Address 17034 N. Earle River Loon Ste 204 FaPIP River,AK 99577 Engineer's Printed Name Robert A. Shafer Al jL%j ih: yl I 49�LH+ :,►� 1Gr 5. DSD SIGNATURE Approved for bedrooms. C00n K Williams 4-4 CE -9867 •���^• Disapproved. ✓ Conditional approval for CS_ bedrooms, with the following stipulations: At the time of closing;nthd,new property owner shall sign the attached maintenance agreement which shall be returned to this office before an unconditional approval is issued. This conditional approval expires on 7/31/2005. Additional Comments AND_ Attachments:-//-�U�/'IEFf��j1��� HAA Checklist X Maintenance Ag��ements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: / 111 f . uil , Wl ink Q-0 am Original Certificate Date: (Rw 01M2) Municipality of Anchorage Development Services Department Building Safety Division ° On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Ler �/I L7S� 5 It, Parcel ID: DSO A. WELL DA Well type (IdVA M If A, B, or C provide PWSID # = Well Log 6N) 6 Date completed 10 ZI�Oq Sanitary seal 499) _)!L5 Wires properly protected®N) �JM— Total depth .5w ft. Cased to 2_tLfta1C Casing height (above ground) 42 ' Date of test Static water level FROM WELL LOG 0 2b 0 bb ft. Well production 1.5 g.p.m. WATER SAMPLE RESULTS: / Coliform colonies/100 ml. Nitrate N•� .9X3 Arsenic: — mg./l. Date of sample: 42316.s B. SEPTIC/HOLDING TANK DATA Tank Type/Material SE Pi 1 (_ c Tank size 1000 gal. Number of Compartments _7d AT INSPECTION ►J1Et_D / ft. g.p.m. Other bacteria I_ colonies/100 ml. Collected by: Cs -5 Date installed its glog Cleanouts (�C`L 1) yyos Foundation cleanout 04) A Depression over tank (Y/ C& High water alarm (Y/K) Date of pumping1J �Vlj 2 Pumper - ►a14 " C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft' or fe/bdrm) 2.0 System type I be Length 31.5 r ft. Width 1 Z r ft. Gravel below pipe • S6 r ft. � Lr g Total depth • ft. Eff. absorption area 45a ft2 Monitoring tube F: Depression over field "0 Date of adequacy test 63161O Sy esults (Pass/Fail) For, bedrooms Fluid depth in absorption field before test — in. Water added= gal. New depth= in. Elapsed Time:1=min. Final fluid depth = in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y(0 type) kD O If yes, give date D. LIFT STATION Date installed L 0 Size in gallons 5Sy Manhole/Access&) Y� "Pump on" level at in. "Pump off" level at�in. High water alarm level at �� in. Datum ROM 807(OP1 Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 1W On adjacent lots + t 1 Absorption field on lot IVF) On adjacent lots 1 f70 + Public sewer main N. 14 Public sewer manhole/cleanout !3 llor Sewer /septic service line 2514- Holding tank N Pr SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation I5, Property line Absorption field 1 t Water main " Water service line D Surface water ( b0 + Wells on adjacent lots ( 00 (+— SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: t t Property line 1AA Building foundation j Z Water main N (q Water Service line I Q 14- Surface water lD©I �' Driveway, parking/vehicle storage l Ot 1 Curtain drain NSE' Kl�►JWells on adjacent lots _ F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date HAA Fee $ 5b f i -is-vz r" Date of Payment b 1251D5 Receipt Number�� (Rev. wort Waiver Fee $ Date of Payment Receipt Number 6�-1 t1, � OF Al q. t *:49TH CoIMn K. V%'.:! Wns .* 10 CE•5r-7 ..........,•-* SCS itcri ClkntName rmjectNameltt Client Sample ID Matrix Samoleltoma ks: 1033724001 S & S Engmcerlag Lot4A]kom S/D Lot 4A Rouse S/D Dri Virg Water S&S ENGINEER rrG 907 694 1211 P.02i02 All Dates/I7mts are Alaslo Standard Time PtiatedDAWT'ime 0689&003 16:53 CollectedDatcll5mt 06113!200315:00 Rccct+ed DatoMme 06/23/2003 16:17 TechakalDirecror Stcp4tnczdc Allowable Prep Andyds pwaardtc Reich POL wtt Method Covaina>D L1milt Dot Data Iain Wtess a:taawnt Nino -N 4.73 0.100 MgJL SPA 300.0 3 (.0101 06NM JIB Microbiology I:aboratory Total Coliform 1OB,NoCall coVlOpmL SM2092238 A (4'7) 0623/05 w TOTAL P.02 ztBci e m ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: Ao✓�ElCid �orS%9 AND THAT NO "CROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EEMEN, COVENANTSOR WHICH DOTS TNOT APPEAR ON, THE RECORDEDIONS SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALES j -w DATE, GRID: iY�vzsY FB: DRAWN: .Zl�� 91vai] OF AZ 1 1 TMS d D.... Mark Saw*.Q �r�' LS -6918 't a ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEENW U�NICIPALITY OF ANCHORAGE AND &Cn± jCi c _ THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this day of JLI-La— of 20 -by and between lac Efi+ kCr) herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater .�4 Treatment System (AIVVJTS), described as c�e:SS%� -�p�� z3 `�� , � t MJE�)ocated at Pir., =,L, ,,/(Z_L—my wq , Anchorage, Alaska. M2. Deions. A. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. _ Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an ANNrWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Omer shall pay to Municipality an annual fee of ZC�> ($�.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. ronwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Remova] of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWVv7S in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the O,. per's AN` VTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AVINVTS Operating Permit is: _gn�j_).nx\ C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Lay. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. SeverahiliN. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. ONNINEER: Date: I\iUNICIPALITI': By: Title: Date: STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day ofSxr,-a 200S -by 6-2r\.A' the 6h3rLq-- of 6l- 41 EnL51�, on behalf of the Municipality of Anchorage. ,IC FOR ALASKA expires: 3—,25-0-t